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Polio Outbreak in Syria a Threat to Europe

Synopsis: Recent tests confirmed polio in children in Deir al-Zour Province Syria and officials are concerned the outbreak may spread in Europe.1

Author: Disabled World

Published: 2013-11-18

Main Digest

An outbreak of polio in children who live in the nation of Syria has been confirmed by the United Nations.

Often called polio or infantile paralysis, is an acute, viral, infectious disease spread from person to person. Although approximately 90% of polio infections cause no symptoms at all, affected individuals can exhibit a range of symptoms if the virus enters the blood stream. Different types of paralysis may occur, depending on the nerves involved. Spinal polio is the most common form, characterized by asymmetric paralysis that most often involves the legs. Bulbar polio leads to weakness of muscles innervated by cranial nerves. Bulbospinal polio is a combination of bulbar and spinal paralysis.

Tests confirmed polio in at least 10 children in Deir al-Zour Province. United Nations officials plan to launch a campaign to vaccinate 2.4 million children in Syria against polio and other diseases. Refugees are fleeing to other countries due to the civil war and vaccination efforts are being increased in Jordan, Lebanon, Turkey, Iraq, Egypt and Israel. Before the start of war, 95% of the population of Syria had been immunized. Health officials are working to identify the source of the disease; it is believed to have started with jihadi fighters from Pakistan where polio remains endemic.

While polio may cause paralysis and even death, the majority of people who are infected with the polio-virus do not experience illness and remain unaware of the fact that they have been infected with polio. What follows are descriptions of the symptoms associated with forms of polio.

Chart showing signs and symptoms of post-polio syndrome
Chart showing signs and symptoms of post-polio syndrome

Paralytic Polio: Rarely, infection with polio-virus leads to paralytic polio, which is the most serious form of the disease. Paralytic polio has several types based on the part of a person's body that is affected; brainstem or, 'bulbar polio,' spinal cord or, 'spinal polio,' or both, 'bulbospinal polio.' The initial signs and symptoms of paralytic polio such as headache and fever mimic those of non-paralytic polio. Within a week's time; however, signs and symptoms specific to paralytic polio appear. These signs and symptoms include:

Post-polio syndrome: involves a cluster of signs and symptoms that affect some people for an average of between 25-35 years after they had polio. Common signs and symptoms of post-polio syndrome include:

Chart showing signs and symptoms of Nonparalytic Polio
Chart showing signs and symptoms of Nonparalytic Polio

Non-paralytic Polio: Some of the people who develop symptoms from the polio-virus contract, 'non-paralytic polio,' which is a form of polio that does not lead to paralysis. It usually causes the same flu-like signs and symptoms common to other viral illnesses. The signs and symptoms usually last 1-10 days and include:

Vaccination of only Syrian refugees against polio might not be enough to prevent the viral disease from re-infecting people in Europe where polio has not been seen for decades, according to German scientists. The scientists say the risk to Europeans from a re-emergence of polio in Syria is partly due to the type of vaccination generally used in regions that have not experienced the disease for a number of years. Polio is caused by a virus transmitted through contaminated water or food; it was confirmed in young children in northwestern Syria very recently. It was the first appearance of Polio in Syria in 14 years.

The World Health Organization (WHO) said the virus most likely spread from Pakistan, 1 of 3 nations where polio remains endemic, and warned the outbreak in Syria posed a threat to millions of children throughout the Middle East. Polio passes easily between people and may spread rapidly between children, particularly in the unsanitary conditions displaced people in Syria endure, or in refugee camps that are crowded in nearby nations. The disease invades a person's nervous system and has the potential to cause irreversible paralysis within a few hours. The WHO's repeated warning is that as long as any single child remains infected with polio, children everywhere remain at risk.

The majority of European countries use inactivated polio vaccine (IPV) instead of oral polio vaccination (OPV), which is a live form of immunization. While IPV is very effective in preventing polio, it only provides partial protection from infection and is less reliable if the virus is circulating. Large numbers of Syrian refugees are leaving Syria for nearby nations and Europe. The potential for polio to be re-introduced into areas that have been free of polio for decades now exists.

Only 1 in 200 people who are un-vaccinated will develop acute flaccid paralysis. People who are infected can spread the polio virus unrecognized. Inactivated polio vaccine (IPV), used across Europe, only partly prevents those vaccinated from infection. It does reduce transmission and is effective in preventing acute flaccid paralysis. IPV reduces the ratio of acute flaccid paralysis to infection.

Oral polio vaccination (OPV) provides high protection against acquisition and spreading of the infection, but the vaccine was discontinued in Europe due to rare instances of vaccination-related acute flaccid paralysis. Only some of the European Union member states still permit the use of OPV and none of them have a stockpile of OPV. Routine screening of sewage for polio-virus has not been performed in most of Europe, but intensified surveillance measures should be considered for settlements with large numbers of refugees from Syria.

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Cite Page: Journal: Disabled World. Language: English (U.S.). Author: Disabled World. Electronic Publication Date: 2013-11-18. Last Revised Date: 2013-11-18. Reference Title: Polio Outbreak in Syria a Threat to Europe, Source: <a href=>Polio Outbreak in Syria a Threat to Europe</a>. Abstract: Recent tests confirmed polio in children in Deir al-Zour Province Syria and officials are concerned the outbreak may spread in Europe. Retrieved 2021-03-01, from - Reference Category Number: DW#445-9951.